Task Shifting to End Preventable Maternal/Child Death in Kenya and Zambia

During the month of May, IMPACT will be highlighting USAID’s work in Global Health.

A mother and her baby. Photo Credit: USAID

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Bondo, Kenya — Babies Gabriel and Mary show the progress that Kenya is making in moving towards an AIDS-free generation. Although their mothers are HIV-positive, the two babies were born free from the virus that causes AIDS thanks to a team of determined community health workers who recruited their young mothers into a project funded by the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. Agency for International Development (USAID). The project, carried out by USAID’s flagship Maternal and Child Health Integrated Program (MCHIP), which is led by Jhpiego, connects women to—and keeps them enrolled in—high-quality health care to prevent the transmission of HIV from mother-to-child.
Mothers Beatrice and Grace are grateful they met community health worker Jane Akoth. After recruiting them into the project, Akoth saw both women regularly, through home visits or appointments at the clinic, to ensure that they remained healthy during and after their pregnancies. “After I delivered my baby, Jane advised me on how to take care of my child by exclusive breastfeeding for six months and to continue taking my medication,” adds Grace, the mother of baby Mary. “I want Jane to continue doing what she is doing so that she can help other mothers.”

In Africa, HIV and AIDS affects women and mothers at a greater rate than men, creating a heavy disease burden among families. When parents die of the disease, children are left orphaned or given to the care of relatives who may not have the means to raise them. Pregnant and breastfeeding women who are infected with HIV also run the risk of transmitting the disease to their children but antiretroviral drugs can dramatically reduce the risk of vertical transmission. [AE1]

The experience of Beatrice and Grace shows that the transmission of this life-threatening virus is indeed preventable. The success of the MCHIP project was due in part to an innovative strategy that was originally developed to improve immunization of children, which links pregnant women to care and keeps them enrolled.

More than 300 community health workers like Jane are working in Bondo District to keep the next generation alive and healthy. Since 2010, coverage through this project has expanded so that women in the most hard to reach areas are being connected to health services. As a result, the percentage of expectant mothers going to all four antenatal care visits increased from 25 percent to 41 percent in two years, and the percentage of HIV-exposed infants who were tested for HIV increased from 27 percent to 78 percent.

We know that follow-up by community health workers is key to saving lives—getting mothers into care, keeping them there, and providing them with the lifesaving medications that they and their children need.